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Updated: Dec 26, 2025
Immunometabolic Circuits in Infection for Advancing Host Directed Therapies
Published on: September 13, 2024
Recent advances and future directions in the management of the immunocompromised host
Konrad Bochennek1, Marie Luckowitsch1, Thomas Lehrnbecher1
1Division for Pediatric Hematology and Oncology, Hospital for Children and Adolescents, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany.
Insights
Infectious complications pose significant risks for pediatric cancer patients. Personalized anti-infective strategies and improved diagnostics are crucial for better outcomes in children undergoing cancer therapy or stem cell transplantation.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Hematopoietic Stem Cell Transplantation
Background:
- Infectious complications are a primary cause of morbidity and mortality in pediatric cancer patients and those undergoing hematopoietic stem cell transplantation (HSCT).
- Current infection risk prediction models require refinement for personalized anti-infective strategies in this vulnerable population.
- Diagnostic tool performance may vary between pediatric and adult patients, necessitating pediatric-specific assessments.
Purpose of the Study:
- To highlight the need for improved risk-prediction models for infections in pediatric cancer patients.
- To emphasize the importance of developing and validating pediatric-specific diagnostic tools for early and reliable infection detection.
- To address the ongoing debate regarding the balance between benefits and risks of prophylactic anti-infective therapies in children.
Main Methods:
- Review of current supportive care strategies and risk-prediction models in pediatric oncology and HSCT.
- Analysis of the limitations of existing diagnostic tools in the pediatric population.
- Discussion of the challenges and considerations in systemic antibacterial and antifungal prophylaxis.
Main Results:
- Existing risk-prediction models for infections in pediatric cancer patients need refinement for personalization.
- Pediatric-specific diagnostic tools and combinations require further assessment to improve early infection diagnosis.
- The use of prophylactic antibacterial and antifungal agents presents a complex balance between reducing infections and increasing resistance.
Conclusions:
- Significant research gaps remain in optimizing supportive anti-infective care for children undergoing cancer therapy or HSCT.
- Development of pediatric-specific clinical practice guidelines has progressed, but further efforts are essential.
- Personalized approaches to infection prevention and diagnosis are critical for improving outcomes in pediatric oncology and HSCT.
Abstract:
Infectious complications are still a major cause of morbidity and mortality in children receiving therapy for cancer or undergoing hematopoietic stem cell transplantation. Current supportive care strategies consider numerous factors for defining the risk for an infection, but these risk-prediction models need to be refined to ultimately personalize anti-infective measures for an individual patient. It has been recognized that the performance of diagnostic tools including serum markers and imaging may differ between children and adults, and future studies have to assess in the pediatric population the combination of specific diagnostic tools in order to improve the early and reliable diagnosis of an infection. There is an ongoing debate on systemic anti-bacterial and antifungal prophylaxis, as these strategies have to weigh individual benefits of reducing infectious complications against the risk of increasing resistance rates in patients and within institutions. Although there was considerable progress in supportive anti-infective care strategies in children and adolescents over the last 2 decades, which resulted in the development of pediatric specific clinical practice guidelines, major effort is needed to close the open research gaps.
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